Service d'Imagerie Guilloz, CHU Nancy, 29 Ave du maréchal de Lattre de Tassigny, CO n 34, Nancy 54035, France.
AJR Am J Roentgenol. 2012 Jan;198(1):180-6. doi: 10.2214/AJR.11.6374.
The purpose of our study was to define the diagnostic value of tomosynthesis compared with standard radiography and CT in wrist injuries.
One hundred consecutive patients with acute wrist trauma were investigated with standard radiography, tomosynthesis, and CT. Reference results were those obtained with CT; follow-up monitoring of the patients; and, in some cases, MRI (n=13). Three readers interpreted the findings independently, each using a PACS workstation, and categorized the cases into four groups: fracture of the radius, fracture of the scaphoid, fracture of another bone, and absence of fracture.
Fifty-seven percent of the patients had a fracture. The interobserver kappa value varied between 0.54 and 0.59 for standard radiography, between 0.66 and 0.69 for tomosynthesis, and between 0.84 and 0.89 for CT. The sensitivity of standard radiography varied between 61% and 80% and specificity between 65% and 83%. The sensitivity of tomosynthesis ranged between 77% and 87%, and specificity between 76% and 82%. Ranges of sensitivity and specificity for CT were 93-95%, and 86-95%, respectively.
The diagnostic value of tomosynthesis is superior to that of standard radiography but inferior to that of CT.
本研究旨在比较断层合成摄影与标准 X 线摄影和 CT 在腕部损伤中的诊断价值。
对 100 例急性腕部创伤患者分别进行标准 X 线摄影、断层合成摄影和 CT 检查。参考结果为 CT 结果；对患者进行随访监测；在某些情况下还进行了 MRI（n=13）检查。三位观察者分别使用 PACS 工作站独立解读结果，并将病例分为四组：桡骨骨折、舟状骨骨折、其他骨骨折和无骨折。
57%的患者有骨折。标准 X 线摄影的观察者间 κ 值在 0.54 到 0.59 之间，断层合成摄影的 κ 值在 0.66 到 0.69 之间，CT 的 κ 值在 0.84 到 0.89 之间。标准 X 线摄影的灵敏度在 61%到 80%之间，特异性在 65%到 83%之间。断层合成摄影的灵敏度在 77%到 87%之间，特异性在 76%到 82%之间。CT 的灵敏度和特异性范围分别为 93-95%和 86-95%。
断层合成摄影的诊断价值优于标准 X 线摄影，但劣于 CT。
